The proposed independent scientist award (K02) is aimed at improving the quality of primary care for complex pediatric patients by developing a set of comprehensive and multi-dimensional quality assessment tool (QA Tool). The epidemiology of disease has changed in the modern era, with the burden of illness shifted from acute conditions to chronic conditions. As a result, there are growing concerns that the traditional care delivery model may no longer be effective. Children today also bear a remarkably high chronic disease burden - many pediatric patients survive extremely premature birth, live with multiple congenital defects, and suffer from multiple disabling conditions. These children are managed by multiple providers, including generalists, specialists, school healthcare personnel, and therapists. The complex and chronic nature of these conditions, coupled with fragmented care across multiple providers, can lead to inconsistent and poor outcomes. The American Academy of Pediatrics strongly advocate for a "patient-centered medical home" care delivery model for the primary care of complex pediatric patients. The pediatric medical home is a primary care setting, led by a general physician, that promotes accessible, continuous, comprehensive, family-centered, coordinated, compassionate, culturally-effective care. Although the medical home concept has garnered public and professional support, it faces practical challenges in the lack of health plan reimbursement and rigorously developed quality standards. As an independent scientist candidate, I propose to collaborate with renowned experts and pioneers in quality of care research (Drs. Mangione-Smith and Brook) to develop a comprehensive set of medical home driven quality of care measures for the healthcare and management of complex pediatric patients, using a rigorous and validated modified Delphi process developed by RAND. The proposed project is in line with AHRQ's mission to improve health care for all Americans and its current emphasis to improve the quality of care for medically complex patients.